Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,677.35 / $20,892.96	Facility		$2,818.38	$4,677.35	$20,892.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,949.84 / $4,570.88	Professional		$1,621.81	$1,949.84	$4,570.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $707.95 / $954.99	Facility		$501.19	$707.95	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,884.03 / $5,248.07	Professional		$1,380.38	$2,884.03	$5,248.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,235.94 / $4,570.88	Facility		$1,737.80	$3,235.94	$4,570.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,884.03 / $4,570.88	Professional		$1,698.24	$2,884.03	$4,570.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $776.25	Professional		$32.36	$33.11	$776.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,467.37 / $3,630.78	Facility		$2,884.03	$3,467.37	$3,630.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,715.35 / $5,128.61	Professional		$2,398.83	$3,715.35	$5,128.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $3,388.44 / $4,466.84	Professional		$2,691.53	$3,388.44	$4,466.84
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $5,754.40	Facility		$707.95	$1,258.93	$5,754.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,511.89 / $4,466.84	Professional		$1,698.24	$2,511.89	$4,466.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $1,905.46 / $3,090.30	Professional		$1,621.81	$1,905.46	$3,090.30